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Late-onset multiple sclerosis mimicking brain tumor: A case report

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Abstract

Multiple sclerosis (MS) is a demyelinating disease that predominantly affects those aged in their twenties to their forties. We recently observed a case of rapidly progressive late-onset MS in an elderly patient with a large, single lesion on magnetic resonance imaging (MRI), which was difficult to distinguish from a brain tumor. This case is reported here with a review of the literature. A 69-year-old woman who presented with left hemiparesis was admitted to our institute. A tumor lesion was strongly suspected from the MRI finding of a large solitary lesion adjacent to the right lateral ventricle. Her left hemiparesis became rapidly worse, so we decided to perform stereotactic biopsy. Histopathological examination indicated that the patient had a demyelinating disease such as multiple sclerosis. Steroid pulse therapy was started after the operation and led to a marked improvement of the symptoms. With follow-up for more than 1 year after discharge, she has shown no sign of relapse. Late-onset MS should be suspected if edema or mass effect is not visualized around the lesion on MRI, bearing in mind that late-onset MS can have a progressive course in elderly patients.

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References

  1. Leibowitz U, Alter M, Halpern L (1964) Clinical studies of multiple sclerosis in Israel. III. Clinical course and prognosis related to age of onset. Neurology 14:926–932

    PubMed  CAS  Google Scholar 

  2. Ikeda K, Kinosita M, Kurihara T, et al (1992) An autopsy case of multiple sclerosis of late onset: with a review of literature. Neurol Med 36:589–595

    Google Scholar 

  3. Azzimondi G, Stracciari A, Rinaldi R, et al (1994) Multiple sclerosis with very late onset: report of six cases and review of the literature. Eur Neurol 34:332–336

    PubMed  CAS  Google Scholar 

  4. Cazzullo CL, Ghezzi A, Marforio S, et al (1978) Clinical picture of multiple sclerosis with late onset. Acta Neurol Scand 58:190–196

    Article  PubMed  CAS  Google Scholar 

  5. Hooge JP, Redekop WK (1992) Multiple sclerosis with very late onset. Neurology 42:1907–1910

    PubMed  CAS  Google Scholar 

  6. Lyon-Caen O, Izgierdo G, Marteau R, et al (1985) Late onset multiple sclerosis. A clnical study of 16 pathologically proven cases. Acta Neurol Scand 72:56–60

    Article  PubMed  CAS  Google Scholar 

  7. Marrab TR (1984) Multiple sclerosis with onset after age 60. J Am Geriatr Soc 32:16–18

    Google Scholar 

  8. Noseworthy J, Paty D, Wonnacott T, et al (1983) Multiple sclerosis after age 50. Neurology 33:1537–1544

    PubMed  CAS  Google Scholar 

  9. Polliack ML, Barak Y, Achiron A (2001) Late — onset multiple sclerosis. J Am Geriatr Soc 49:168–171

    Article  PubMed  CAS  Google Scholar 

  10. Poser S, Raun NE, Poser W (1982) Age at onset, initial symptomatology and the course of multiple sclerosis. Acta Neurol Scand 66:355–362

    Article  PubMed  CAS  Google Scholar 

  11. White AD, Swingler RJ, Compston DAS (1990) Feature of multiple sclerosis in older patients in South Wales. Gerontology 36:159–164

    Article  PubMed  CAS  Google Scholar 

  12. Fazekas F, Offenbacher H, Fuchs S, et al. (1988) Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 38:1822–1825

    PubMed  CAS  Google Scholar 

  13. Mitchell LA (1998) Radiology quiz. MRI in the diagnosis of multiple sclerosis. Aust Fam Physician 27:631–633

    PubMed  CAS  Google Scholar 

  14. Scotti G, Scialfa G, Biondi A, et al (1986) Magnetic resonance in multiple sclerosis. Neuroradiology 28:319–323

    Article  PubMed  CAS  Google Scholar 

  15. Paty DW, Oger JJF, Kastrukoff LF, et al (1988) MRI in the diagnosis of MS: a prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT. Neurology 38:180–185

    Article  PubMed  CAS  Google Scholar 

  16. Kurihara N, Takahashi S, Furuta A, et al (1996) MR imaging of multiple sclerosis simulating brain tumor. Clin Imaging 20:171–177

    Article  PubMed  CAS  Google Scholar 

  17. Laitt R, Birchall D, Jackson A (1995) An unusual cerebral mass lesion. Postgrad Med J 71:427–429

    PubMed  CAS  Google Scholar 

  18. Mastrostefano R, Occhipinti E, Bigotti G, et al (1987) Multiple sclerosis plaque simulating cerebral tumor: case report and review of the literature. Neurosurgery 21:244–246

    PubMed  CAS  Google Scholar 

  19. Paley RJ, Persing JA, Doctor A, et al (1989) Multiple sclerosis and brain tumor: a diagnostic challenge. J Emerg Med 7:241–244

    Article  PubMed  CAS  Google Scholar 

  20. Giang DW, Poduri KR, Eskin TA, et al (1992) Multiple sclerosis masquerading as a mass lesion. Neuroradiology 34:150–154

    Article  PubMed  CAS  Google Scholar 

  21. Kepes JJ (1993) Large focal tumor-like demyelinating lesions of the brain: intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis? A study of 31 patients. Ann Neurol 33:18–27

    Article  PubMed  CAS  Google Scholar 

  22. Otuka S, Nakatsu S, Matsumoto S, et al (1989) Multiple sclerosis simulating brain tumor on computed tomography. J Comput Assist Tomogr 13:674–678

    Article  Google Scholar 

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Iwamoto, K., Oka, H., Utsuki, S. et al. Late-onset multiple sclerosis mimicking brain tumor: A case report. Brain Tumor Pathol 21, 83–86 (2004). https://doi.org/10.1007/BF02484515

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  • DOI: https://doi.org/10.1007/BF02484515

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